HX64111997 
RA982.N48  N481  1909  By-laws  and  rules  of 


tyqt  fctaamlt  if usptial 


BY-LAWS  AND   RULES 


AMENDED    OCTOBER,     1909 


K*{?8Z./v'¥8 


~M?8/ 


Columbia  $totoer*itj> 

College  of  ipfjpgtcianfii  ano  burgeon* 
Hturarp 


BY-LAWS  AND  RULES 

OF 

The  Roosevelt  Hospital 

Including  the  Rules  of 

THE  TRAINING  SCHOOL  FOR  NURSES 

Amended  October,  J  909 


-RA  9«.  W 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/bylawsrulesofrooOOnewy 


The   Roosevelt   Hospital 

Occupies  the  block  of  ground  between  58th  and  59th  Streets  and 
9th  and  10th  Avenues,  and  has  erected  thereon  suitable  buildings, 
which  furnish  accommodations  for  about  two  hundred  and  thirty- 
seven  patients.  It  was  opened  for  the  treatment  of  medical  and 
surgical  patients  November  2,  1871.  The  Ambulance  Service, 
which  was  established  in  1878,  was  discontinued  in  1909.  The 
Out-Patient  (Dispensary)  Department  was  added  in  1881.  The 
Gynsecological  Division  was  separated  from  the  Medical  in  1888. 
The  McLane  Operating  Room,  the  gift  of  Dr.  James  W.  Mc- 
Lane,  in  memory  of  James  W.  McLane,  Jr.,  for  the  use  of  the 
Gynsecological  service,  was  opened  in  1890.  The  Wm.  J.  Syms 
Memorial  Operating  Theatre  was  erected  in  1892,  and  the  Private 
Patients'  Pavilion  in  1896.  The  Training  School  for  Nurses 
was  organized  in  1896.  The  Accident  Building  was  erected  in 
1898,  providing  in  the  first  story  for  treatment  of  emergency 
and  accident  cases,  and  in  the  second  story  a  Medical  Ward 
(opened  in  February,  1899),  to  be  known  as  the  Catherine  A. 
Bliss  Ward  for  Sick  Children,  the  beds  in  which  (12)  were 
endowed  by  Miss  Catherine  A.  Bliss.  The  power  plant  was 
erected  and  equipped  in  1903  by  Mrs.  George  Theodore  Bliss 
in  memory  of  her  husband.  A  new  up-to-date  laundry  and 
kitchen,  a  new  executive  office,  a  recreation  room  for  the  staff,  a 
new  carpenter  shop  and  extensive  fresh  air  balconies  have  since 
been  constructed  and  equipped  by  friends  of  the  Hospital.  The 
Pathological  Service  was  reorganized  in  1909  and  a  new  build- 
ing, fully  equipped,  was  provided  for  its  accommodation. 

To  erect,  furnish  and  maintain  the  buildings,  according  to  the 
plans  adopted,  will  require  additional  money  beyond  the  funds 


provided  by  Mr.  Roosevelt's  Will;  and  the  Trustees  solicit  con- 
tributions for  this  purpose,  and  for  the  endowment  of  free  beds. 
A  donation  of  five  thousand  dollars  entitles  the  donor  to 
nominate  patients  to  a  free  bed  in  perpetuity;  and  a  donation  of 
three  thousand  dollars  entitles  the  donor  to  nominate  patients  to 
a  free  bed  for  the  life  of  the  donor. 


CHARTER 

AN  ACT  to  incorporate  "The  Roosevelt  Hospital,"  in  the  City 

of  New  York.     Passed  February  2d,  1864,  three-fifths  being 

present. 
The  people  of  the  State  of  New  York,  represented  in  Senate  and 

Assembly,  do  enact  as  follows : 

Section  i.  It  being  represented  to  this  Legislature,  that  James 
H.  Roosevelt,  late  of  the  city  of  New  York,  departed  this  life,  in 
the  month  of  November,  eighteen  hundred  and  sixty-three  (never 
having  married),  possessed  of  a  large  real  and  personal  estate, 
the  bulk  of  which  by  his  will  he  devoted  to  the  establishment  of 
a  Hospital  in  said  city,  naming  for  that  purpose  certain  trustees 
to  manage  and  conduct  the  same,  and  directing  them  promptly 
to  apply  to  the  Legislature  of  this  State  for  proper  acts  to  incor- 
porate, secure  and  perpetuate  said  Hospital,  and  such  application 
having  been  made  accordingly:  Be  it,  therefore,  enacted,  That 
the  trustees  named  in  said  will,  to  wit,  George  T.  Trimble,  Presi- 
dent of  the  Managing  Board  of  "The  Society  of  the  New  York 
Hospital,"  Edward  Delafield,  President  of  the  Managing  Board 
of  "The  College  of  Physicians  and  Surgeons  in  the  City  of 
New  York,"  Thomas  House  Taylor,  President  of  the  Managing 
Board  of  "The  New  York  Eye  and  Ear  Infirmary,"  Frederick  E. 
Mather,  President  of  the  Managing  Board  of  "The  Demilt  Dis- 
pensary," Augustus  Schell,  President  of  the  Managing  Board  of 
"The  New  York  Institute  for  the  Blind,"  and  their  several  suc- 
cessors in  their  respective  offices  as  such  Presidents,  and  James 
I.  Roosevelt,  Edwin  Clark,  John  M.  Knox,  and  Adrian  H.  Muller, 
all  of  the  city  of  New  York,  and  their  successors,  are  hereby  in- 
corporated and  declared  to  be  a  body  politic  and  corporate  by  the 
name  of  "The  Roosevelt  Hospital." 


Sec.  2.  The  object  of  the  said  corporation  shall  be  the  estab- 
lishment in  the  city  of  New  York  of  a  Hospital  for  the  reception 
and  relief  of  sick  and  diseased  persons,  and  its  permanent  endow- 
ment pursuant  to  the  directions  of  the  last  will  and  testament  of 
its  founder  as  aforesaid. 

Sec.  3.  The  direction  and  management  of  the  affairs  of  said 
Corporation,  and  the  control  and  disposition  of  its  property  and 
funds  shall  be  vested  in  said  trustees  and  their  successors.  In 
case  of  any  vacancy  from  death,  resignation  or  otherwise,  of  any 
of  the  four  individual  trustees  herein  designated  by  name,  and 
not  by  title  of  office,  or  their  successors,  then  and  in  every  such 
case  the  vacancy  so  occurring  shall  be  supplied  by  the  surviving 
or  remaining  trustees  from  male,  native  born  citizens,  then  resi- 
dent in  the  city  of  New  York.  The  property,  real  and  personal, 
of  said  Corporation  shall  be  exempt  from  taxation,  and  shall  be 
entitled  to  the  benefit  of  the  provisions  of  law  relative  to  charitable 
institutions. 

Sec  4.  The  Trustees  of  said  Corporation  shall  elect  one  of 
their  number  President,  who  shall  hold  his  office  during  their 
pleasure,  and  they  may  also  elect  or  appoint,  and  at  any  time  re- 
move, a  secretary  and  a  treasurer,  and  such  other  officers  as,  in 
their  judgment,  the  management  of  its  affairs  may  require. 

Sec.  5.  The  said  Corporation  shall  be,  and  is  hereby  em- 
powered— 

1.  To  demand  and  receive  from  the  executrix  of  the  last  will 
and  testament  of  the  said  James  H.  Roosevelt,  as  proven  on  the 
sixteenth  day  of  December,  eighteen  hundred  and  sixty-three, 
and  recorded  in  the  office  of  the  Surrogate  of  the  county  of 
New  York,  and  from  the  residuary  legatees  named  in  said  will, 
all  personal  property  and  real  estate,  and  the  proceeds  of  all  per- 
sonal property  and  real  estate  in  any  manner  devised  or  be- 
queathed by  the  said  will  for  the  establishment  in  the  city  of 
New  York  of  a  Hospital  as  aforesaid,  for  the  reception  and  relief 

6 


of  sick  and  diseased  persons,  and  for  its  permanent  endowment. 

2.  To  purchase  and  hold  real  estate  in  the  city  of  New  York, 
and  erect  and  maintain  thereon  suitable  buildings  for  the  use  of 
said  Hospital. 

3.  Upon  the  sale  of  the  real  estate  of  the  said  James  H.  Roose- 
velt, as  provided  in  said  will,  to  purchase  and  hold  the  whole 
or  any  part  thereof  as  the  Corporation  may  determine. 

4.  To  invest  all  funds  of  this  Corporation  not  otherwise  specifi- 
cally appropriated,  whether  derived  from  the  estate  of  said  James 
H.  Roosevelt,  or  otherwise,  either  on  bond,  secured  by  mortgage 
on  unincumbered  improved  real  estate  in  fee,  in  the  city  of 
New  York,  or  in  public  stocks  of  the  City  or  State  of  New  York, 
or  of  the  United  States  of  America. 

Sec.  5.  The  said  Corporation  may  take  and  hold  any  additional 
donations,  grants,  devises  and  bequests  which  may  be  made  in 
further  support  of,  or  addition  to  said  Hospital — so  far  forth  as 
the  same  is  in  accordance  with  the  general  laws  of  the  State, 
and  not  otherwise. 

Sec.  6.  The  said  Corporation  shall  possess  the  power,  and  be 
subject  to  the  provisions,  liabilities,  and  restrictions  contained  in 
the  third  title  of  the  eighteenth  chapter  of  the  first  part  of  the 
Revised  Statutes,  except  as  is  otherwise  provided  in  this  Act. 
Sec.  7.  This  Act  shall  take  effect  immediately. 
State  of  New  York, 
Office  of  the  Secretary  of  State. 

I  have  compared  the  preceding  with  the  original  law  on  file  in 
this  office,  and  do  hereby  certify  that  the  same  is  a  correct  tran- 
script therefrom,  and  of  the  whole  of  said  original  law. 

Given  under  my  hand  and  seal  of  office,  at  the  city 
[l.  s.]         of  Albany,  this  4th  day  of  February,  in  the  year 
one  thousand  eight  hundred  and  sixty-four. 
Chauncey  M.  Depew, 

Secretary  of  State. 
7 


CHAPTER  375. 

AN  ACT  to  amend  Chapter  four  of  the  laws  of  eighteen  hun- 
dred and  sixty-four,  entitled  "An  act  to  incorporate  The  Roose- 
velt Hospital  in  the  city  of  New  York,"  in  relation  to  the  election 
of  additional  trustees  and  the  filling  of  vacancies. 

Accepted  by  the  City. 

Became  a  law,  May  5,  1905,  with  the  approval  of  the  Governor. 
Passed,  three-fifths  being  present. 

THE  PEOPLE  OF  THE  STATE  OF  NEW  YORK,  REP- 
RESENTED IN  SENATE  AND  ASSEMBLY,  DO  EN- 
ACT AS  FOLLOWS : 
Section  i.  Chapter  four  of  the  laws  of  eighteen  hundred  and 
sixty-four,  entitled  "An  act  to  incorporate  The  Roosevelt  Hospital 
in  the  city  of  New  York,"  is  hereby  amended  by  inserting  there- 
in a  new  section  to  be  section  i-a  thereof  and  to  read  as  follows : 

i-a.  The  present  trustees  of  The  Roosevelt  Hospital  or  a 
majority  of  them,  shall  forthwith  elect  two  male,  native  born 
citizens,  resident  in  the  city  of  New  York,  as  trustees,  in  addi- 
tion to  the  nine  named  in  the  first  section  of  this  act,  and  the  eleven 
trustees  and  their  successors  shall  be  the  body  corporate  by  the 
name  of  and  known  as  "The  Roosevelt  Hospital." 

2.  Section  three  of  such  chapter  is  hereby  amended  to  read  as 
follows : 

3.  The  direction  and  management  of  the  affairs  of  said  Cor- 
poration, and  the  control  and  disposal  of  its  property  and  funds, 
shall  be  vested  in  said  trustees  and  their  successors.  In  case  of 
any  vacancy  from  death,  resignation,  or  otherwise  of  any  of  the 
six  individual  trustees,  or  their  successors,  then  and  in  every 
such  case,  the  vacancy  so  occurring  shall  be  supplied  by  the 
surviving  or  remaining  trustees,  from  male  native  born  citizens 

8 


then  resident  in  the  city  of  New  York.     The  property,  real  and 
personal,  of  said  Corporation,   shall  be  exempt  from  taxation, 
and  shall  be  entitled  to  the  benefit  of  the  provisions  of  law  relat- 
ing to  charitable  institutions. 
4.  This  act  shall  take  effect  immediately. 


The   Roosevelt   Hospital 


by-laws 

OF    THE    BOARD    OF    TRUSTEES 


OFFICERS. 
i.  There  shall  be  a  President,  Vice-President, 
Secretary  and  Treasurer,  who  shall  respectively  discharge  the 
usual  duties  of  such  officers. 

ELECTION  OF  OFFICERS. 

2.  The  officers  shall  be  elected  by  ballot  at  the 
stated  meeting  of  the  Board,  in  the  month  of  February,  in  each 
year;  and  shall  hold  office  until  their  successors  shall  be  ap- 
pointed, unless  sooner  removed  by  the  Board.  Any  vacancy  shall 
be  filled  by  the  Board. 

SECRETARY. 

3.  The  Secretary  shall  have  the  custody  of  the 
seal  of  the  Corporation,  and  shall  affix  it  to  such  documents  only 
as  the  Board  of  Trustees  may  direct.  He  shall  also  execute  on 
behalf  of  the  Hospital  all  satisfactions  of  mortgages  belonging 
to  the  Hospital. 

TREASURER. 

4.  The  Treasurer  shall  have  the  care  of  all 
money,  bonds,  title-deeds  and  other  papers  relating  to  the  prop- 
erty of  the  Corporation.  He  shall  also  have  charge  of  all  the 
real  estate  of  the  Corporation,  except  the  Hospital  buildings,  but 

10 


with  no  authority  to  let  or  lease  any  portion  of  the  same  without 
direction  of  the  Finance  Committee  or  President  of  the  Board. 

He  shall  keep  an  account  in  one  or  more  of  the 
banks  or  trust  companies  of  this  city,  approved  by  the  Board,  in 
the  name  of  this  Corporation,  and  deposit  therein  all  money  re- 
ceived by  him. 

He  shall  not  pay  any  money  without  direction 
of  the  Board  of  Trustees,  or  of  a  committee  duly  authorized  by 
them  to  draw  on  him. 

He  shall  cause  the  necessary  books  and  ac- 
counts to  be  kept  as  directed  by  the  Board  or  Finance  Committee. 

COMMITTEES. 
finance  e;.  The    Finance    Committee    shall    consist    of 

three  members  of  the  Board,  and  shall  be 
elected  at  the  annual  meeting.  They  shall  have  charge  and  man- 
agement of  the  property  of  the  institution,  in  conformity  with 
the  direction  of  the  Board  of  Trustees.  A  majority  of  the  Finance 
Committee  shall  have  authority  to  direct  the  Treasurer  of  the 
Roosevelt  Hospital  to  sell,  assign,  and  transfer  any  of  the  securi- 
ties of  the  Hospital  registered  in  the  name  of  the  Hospital. 

building  5#  a    Committee   on   Buildings   to   consist   of 

COMMITTEE.  ,«,,,-, 

three  members  shall  be  elected  when  any 
additional  buildings  on  the  Hospital  Grounds  are  about  to  be 
undertaken. 

visiting  j%  At  the  meeting  of  the  Board  in  February  of 

COMMITTEE.  . 

each  year,  or  at  the  next  succeeding  meeting, 
the  President  shall  appoint  two  members  of  the  Board  to  serve 
on  the  Visiting  Committee  for  each  month  of  the  ensuing  year, 
and  he  shall  fill  any  vacancies  on  the  Committee  that  may  occur. 

They    shall    give    such    orders    and    establish 

11 


such  regulations  as  they  shall  think  proper  to  carry  into  effect  the 
objects  of  the  Institution  in  accordance  with  the  regulations  of 
the  Board  of  Trustees. 

They  shall  receive  or  reject  applicants  for 
admission  in  accordance  with  the  regulations  upon  that  subject, 
and  shall  determine  whether  the  applicant  shall  be  received  as  a 
free  or  pay-patient,  and  in  the  latter  case  they  shall  fix  the  rate 
of  payment. 

to  visit  One  °^  them  snau<  yls^  tne  Hospital  at  least 

weekly.  once  in  each  week;  but  in  the  interval  between 

visits  and  when  the  circumstances  of  the  case  shall  require  it,  the 
Superintendent  may  act  as  their  representative  in  the  admission 
of  patients,  reporting  his  action  in  each  case  to  the  Committee  at 
the  next  visit.  If  only  one  member  of  the  Committee  be  present, 
he  shall  have  all  the  authority  and  powers  of  the  Committee. 

They  shall  see  that  no  patient  is  allowed  to  re- 
main in  the  Hospital  when  in  a  condition  to  be  discharged;  and 
that  all  patients  whose  diseases  may  be  incurable  are  removed. 

They  may,  at  their  discretion,  discharge  any  pa- 
tient or  hospital  attendant  for  disorderly  conduct. 

to  main-  ■""n  case  ^e  Assistant  Superintendent,  Super- 

tain  disci-  intendent  of  Nurses,  House  Physician,  House 

Surgeon,  House  Gynaecologist,  or  any  of  their 
assistants,  or  the  Matron,  Clerk,  Apothecary  or  Engineer  shall 
neglect  any  of  the  duties  prescribed  for  them,  or  refuse  to  comply 
with  any  reasonable  request  of  the  Visiting  Committee  or  Super- 
intendent, the  Visiting  Committee  may  suspend  the  offender  and 
report  the  case  to  the  next  meeting  of  the  Board  of  Trustees,  and 
TO  _|LL  the  vacancy  in  the  meantime  shall  be  supplied 

temporary  by  such  person  as  the  Committee  may  appoint. 

They  are  also  authorized  to  fill  vacancies  on 
the  House  Staff  occurring  during  a  recess  of  the  Board. 

12 


The  Visiting  Committee  shall  have  general 
charge  of  all  property  within  the  precincts  of  the  Hospital  and 
authorize  such  purchases,  repairs  and  disbursements  as  may  from 
time  to  time  be  necessary ;  expenditure  for  any  one  item  exceeding 
$100,  not  for  current  expenses  or  emergency  repairs,  shall  be 
reported  to  the  Board  at  its  next  meeting. 

They  shall  examine  as  to  whether  economy  is 
observed  in  the  several  departments  of  the  Hospital;  as  to  the 
cleanliness  and  order  of  all  parts  of  the  house  and  grounds ;  as 
to  the  quantity  and  quality  of  the  food  given  the  patients,  and 
into  the  conduct  of  the  several  officers  of  the  House. 

training  At  the  meeting  of  the  Board  in  February  of 

school  eacj1  year   or  at  the  next  succeeding  meeting, 

COMMITTEE. 

the  President  shall  appoint  two  members  of  the 
Board  to  serve  as  a  Committee  of  the  Training  School  for  Nurses, 
who  shall  have  general  supervision  of  the  school.  They  shall 
nominate  to  the  Board,  for  diplomas,  nurses  who  shall  have  passed 
the  required  examinations  and  have  served  their  term  in  the 
School  to  the  satisfaction  of  the  Committee  and  of  the  Superin- 
tendent of  Nursers. 

They  shall  have  full  control  of  the  Training 
School  and  may  alter  or  amend  the  "Rules  for  the  Government 
of  the  Training  School,"  subject  to  the  confirmation  of  the  Board. 
They  shall  have  regular  reports  of  the  condition  and  needs  of  the 
Training  School  submitted  to  the  Board  at  its  regular  meetings  by 
the  Superintendent  of  Nurses. 

MEETINGS. 

8.     The  regular  meetings  of  the  Board  shall 

be  held  monthly,  on  the  last  Tuesday  of  each  month ;  but  special 

meetings  may  be  called  by  direction  of  the  President,  or  of  any 

two  of  the  Trustees.     Notices  of  every  meeting  shall  be  issued 

13 


by  the  Secretary,  not  less  than  twenty-four  hours  before  the  time 
of  holding  such  meeting. 

9.  A  Clerk  shall  be  appointed  by  the  Board  to 
assist  its  officers  and  keep  their  books  and  records. 

10.  It  shall  be  a  fundamental  rule  of  this 
Board  that  no  continuous  debt  for  current  expenses  shall  be 
contracted,  nor  shall  the  principal  of  the  permanent  fund  be  im- 
paired for  that  purpose. 

11.  No  member  of  the  Board  of  Trustees 
shall  receive  compensation  in  any  form  for  duties  performed  as 
Trustee  or  officer  of  the  Board. 

12.  Five  members  of  the  Board,  including 
either  the  President  or  Vice-President,  will  constitute  a  quorum 
for  the  transaction  of  business. 

AMENDMENTS. 

13.  No  amendment  or  addition  to  these  By- 
Laws  shall  be  made  except  at  a  stated  meeting,  and  after  the 
amendment  or  addition  shall  have  been  presented  to  the  Board,  in 
writing,  at  a  previous  stated  meeting. 

ORDER  OF  BUSINESS. 

14.  Until  further  direction  of  the  Board  the 
order  oi  business  shall  be  as  follows : 


Reading  the  minutes  of  the  last  meeting. 

Communications  and  action  thereon. 

Reports  of  Committees  and  action  thereon. 

Special  order,  if  any. 

Unfinished  business. 

Motions  and  resolutions. 

Adjournment. 


14 


The   Roosevelt    Hospital 


RULES     FOR     THE     HOSPITAL 

I. 

medical  I#    The  Hospital  shall  be  divided  into  two  surgi- 

DEPARTMENTS.  ,     ,.     .    .  ,.      ,  ,        . 

cal  divisions,  one  medical  and  one  gynaecologi- 
cal division  and  an  out-patient  department. 

II.— OF  THE  CONSULTING  STAFF. 

i.  There  may  be  two  or  more  Consulting  Physi- 
cians, three  or  more  Consulting  Surgeons,  two  or  more  Consult- 
ing Gynaecologists,  one  Consulting  Neurologist,  one  Consulting 
Laryngologist,  one  Consulting  Otologist,  one  Consulting  Der- 
matologist, one  Consulting  Opthalmologist  and  one  Consulting 
Orthopedist. 

2.  They  may  be  consulted  in  cases  of  unusual 
difficulty,  and  invited  to  attend  all  capital  operations. 

III.— OF  THE  ATTENDING  STAFF. 

appoint-  j   All  Physicians,  Surgeons  and  Gynaecologists 

annual  s^a^  ke  annually  appointed  by  the  Board  of 

Trustees  at  the  stated  meeting  of  this  Board 

in  the  month  of  December,  the  appointment  to  take  effect  January 

age  limit  ist  in  each  year,  and  no  one  shall  be  eligible 

for  appointment  who  has  reached  the  age  of  sixty-five  years. 

2.  There  shall  be  two  Surgeons,  two  Junior 
Surgeons,  two  First  Assistant  Surgeons,  two  Second  Assistant 
Surgeons,  three  or  more  Physicians,  one  Junior  Physician,  one  or 
more  Gynaecologist,  one  Junior  Gynaecologist  and  one  Patholo- 
gist. 

15 


3.  Each  Surgeon,  Physician,  and  Gynaecologist 
on  duty  shall  visit  his  division  daily. 

4.  The  Attending  Physicians,  Surgeons  and 
Gynaecologists  shall  have  the  entire  direction  of  the  treatment  of 
patients  in  their  respective  wards.  They  shall  also  exercise  a 
supervision  of  the  condition  of  the  wards,  the  behavior  of  the 
nurses  and  orderlies,  and  the  character  of  the  food  of  the  patients, 
and  report  whatever  they  may  deem  wrong. 

clinics.  They  may  give  clinical  instruction,  illustrated 

by  the  patients  in  their  respective  divisions   (but  clinics  may  be 
held  in  the  wards  only  between  the  hours  of  2  and  4  P.  M.). 

5.  Patients  who  are  admitted  by  the  Super- 
intendent to  private  rooms  without  special  recommendation  from  a 
member  of  the  Medical  Board,  shall  be  assigned  to  the  care  of 
the  attending  Physician,  Surgeon  or  Gynaecologist  on  duty  ac- 
cording to  the  nature  of  their  complaints. 

private  Patients  who  are  recommended  by  a  member  of 

consulting  the  Consulting  Staff  or  by  the  Attending  Phy- 

staff.  sician,  Surgeon  or  Gynaecologist  to  the  Out- 

Patient  Department  for  admission  to  a  private 
room,  may  be  placed  under  the  care  of  the  individual  who  recom- 
mends them,  provided  that  the  treatment  of  such  patients  shall  be 
so  arranged  with  the  Superintendent  and  the  Attending  on  duty, 
as  not  to  conflict  with  the  conduct  of  the  usual  hospital  service. 

The  private  patients  of  each  Surgeon,  Junior 
Surgeon  or  Assistant  Surgeons  shall  be  assigned  to  the  care  of 
the  House  Surgeon  of  the  division  to  which  the  Surgeon  belongs. 

private  Privilege   to   use   the   private   rooms   may   be 

privileges  granted  during  the  pleasure  of  the  Board  to 

Physicians  and  Surgeons,  not  members  of  the 

Attending  Staff,  subject  to  the  conditions  governing  their  use  by 

the  Consulting  Staff. 

16 


Subject  to  the  direction  of  the  Visiting  Com- 
mittee, the  rooms  on  the  first  floor  of  the  Private  Patients'  Pa- 
vilion shall  be  used  for  surgical  patients,  and  those  upon  the 
second  floor  for  medical  and  gynaecological  patients. 

capital  5#     All  capital  surgical  operations  shall  be  per- 

OPERATIONS. 

formed  by  the  Surgeons,  Junior  Surgeons  or 
the  Assistant  Surgeons,  and  all  capital  gynaecological  operations 
by  the  Gynaecologist  or  the  Junior  Gynaecologist.  In  cases  of 
great  emergency  such  operations  may  be  performed  by  one  of  the 
House  Surgeons  or  by  the  House  Gynaecologist,  provided  the 
Surgeon,  Junior  Surgeon  or  Assistant  Surgeon,  or  the  Gynae- 
cologist or  Junior  Gynaecologist  cannot  attend. 

laboratory  7#     Any  member  of  the  Medical  Board  shall 

have  the  privilege  of  using  the  laboratory  of 
the  Hospital  for  the  purpose  of  carrying  on 
special  investigations,  provided  such  investigations  are  undertaken 
by  himself  in  person.  No  member  of  the  Board,  however,  shall 
have  the  privilege  of  introducing  any  assistants  into  the  laboratory 
save  with  the  consent  of  the  Pathologist  of  the  Hospital. 

8.  The  members  of  the  Attending  Staff  give 
their  professional  services  to  the  Hospital  without  salary  under 
the  following  terms  and  conditions: 

when  prof.  (a)     They  will  not  receive  professional   fees 

services  '  . 

shall  be  under  any  circumstances  from  any  patient  oc- 

rendered  cupying  a  bed  in  the  wards  of  the  Hospital, 

without  neither  will  they  expect  or  receive  such  fees 

CHARGE. 

from  any  patient  applying  directly  to  and  re- 
ceived into  the  Hospital  for  accommodation  in 
a  private  room,  provided  that,  in  the  opinion  of  the  Superin- 
tendent, ability  does  not  exist  on  the  part  of  such  patient  to  pay 

17 


for  the  professional  attention  given  besides  paying  first  the  hos- 
pital charges  for  board  and  nursing. 

(b)  It  is  expected  and  required  that  the  mem- 
ber of  the  Attending  Staff  who  recommends  a  patient  for  admis- 
sion to  a  private  room  shall  make  definite  arrangements  regarding 
his  professional  fee  before  such  patient  enters  the  Hospital. 

The  design  of  the  foregoing  rules  is  to  protect 
the  Hospital  authorities  and  Attending  Staff  from  any  misuse  of 
their  charitable  services. 

IV.— OF  THE  PATHOLOGIST  AND  HIS  ASSISTANTS, 
i.     The  Pathologist  and  one  or  more  assistants 
shall  be  appointed  by  the  Board  of  Trustees  on  the  nomination  of 
the  Medical  Board. 

autopsies.  2.     The  Pathologist  shall  make,  or  cause  to  be 

made  by  an  assistant,  all  post-mortem  examinations  on  persons 
dying  in  the  Hospital,  for  which  consent  has  been  obtained  by  the 
Superintendent. 

3.  It  shall  be  the  duty  of  the  Pathologist  or 
his  assistant,  when  making  an  autopsy,  to  cause  it  to  be  recorded 
by  a  member  of  the  House  Staff  in  a  book  kept  for  that  purpose, 
and  himself  to  sign  the  record. 

4.  When  a  post-mortem  examination  is  de- 
sired by  a  member  of  the  Attending  Staff,  that  fact  shall  be 
reported  to  the  Superintendent,  who  will  decide  upon  the  advi- 
sability of  it. 

*>.  The  Pathologist  shall  have  charge  of  all 
logical  specimens  from  post-mortem  examinations,  and 

specimens.  0f  a\\  guch  as  are  removed  by  operation  in  the 

Hospital. 

6.  The  Pathologist  may  give  instructions  in 
pathological  anatomy  in  the  autopsy  room. 

18 


J.  The  necessary  instruments  for  use  in  the 
autopsy  room,  shall  be  in  charge  of  the  Pathologist,  who  will  be 
held  responsible  for  them. 

V.— OF  THE  MEDICAL  BOARD. 
HOW  i.     The     Consulting     Physicians,     Surgeons, 

CONSTITUTED.  _  ,        .  ,   _      ,      ,        .  ,       ™        .    . 

Gynaecologists  and  Pathologist ;  the  Physicians, 
Surgeons,  Gynaecologists  and  Pathologist,  the  Junior  Physician, 
Surgeons  and  Gynaecologist  shall  constitute  the  Medical  Board. 

meetings  and  2.     The  Medical  Board  shall  meet  monthly  on 

ELECTIONS. 

the  Wednesday  preceding  the  last  Tuesday  of 
the  month.  At  its  first  regular  meeting  in  each  year  it  shall  elect 
by  ballot  a  President,  Vice-President  and  Secretary,  who  shall 
perform  the  duties  of  those  offices  respectively.  Three  shall  con- 
stitute a  quorum  of  the  Medical  Board. 

3.  Special  meetings  of  the  Medical  Board  may 
be  called  by  the  Board  of  Trustees  or  by  the  President  of  the 
Medical  Board. 

committees.  4      Said  Board  shall  also  each  year  designate 

two  of  its  number  as  a  Committee  of  Inspection,  and  five  as  a 
Committee  of  Examination  to  consist  of  two  Physicians,  two  Sur- 
geons and  one  Gynaecologist. 

5.  The  Medical  Board  shall  advise  the  Board 
of  Trustees  in  all  matters  pertaining  to  the  health  and  physical 
well-being  of  the  patients  and  shall  regulate  the  diet  of  the  pa- 
tients. It  shall  regulate  the  manner  and  time  of  giving  clinical 
instruction  subject  to  the  rules  of  the  Hospital. 

absences.  6_     Any  physician,  Surgeon  or  Gynaecologist, 

who  has  to  be  absent  for  more  than  a  day  during  his  term  of  duty 
will  arrange  to  have  his  service  attended  to  by  the  Junior  of  his 

19 


Department,  and  notify  the  Visiting  Committee  through  the  Su- 
perintendent of  such  expected  absence,  its  duration,  and  who  will 
attend  in  his  place.  The  Juniors  are  on  duty  and  subject  to  call 
only  during  the  absence  of  the  Physician,  Surgeons  and  Gynae- 
cologists. 

TO  FILL  7-     In  case  of  vacancy  in  the  Medical  Board, 

VACANCIES.  •       ,      11 

it  shall  nominate  to  the  Board  of  Trustees  suit- 
able persons  for  appointment.  It  shall  also  nominate  to  the  Board 
of  Trustees  suitable  persons  for  appointment  as  Attendings  to 
the  Out-Patient  Department,  Assistant  Pathologists  and  the  House 
Staff. 

8.  The  Committee  of  Inspection  shall  per- 
sonally inspect,  at  least  once  a  week,  all  the  Hospital  buildings; 
shall  examine  into  the  condition  of  the  wards,  water-closets  and 
bathing-rooms,  the  quality  of  food  and  medicines  furnished  to 
patients,  and  into  the  conduct  of  the  nurses  and  orderlies,  and 
shall  see  that  all  the  regulations  of  the  Hospital  affecting  patients 
are  properly  enforced ;  it  shall  examine  at  least  once  a  month  into 
the  consumption  of  liquors  for  Hospital  purposes. 

examinations  9#     The  Committee  on  Examinations  shall  ex- 

FOR  . 

house  staff.  amine  all  applicants,  except  as  hereinafter  pro- 

vided, for  appointment  on  the  House  Staff.  An 
examination  shall  be  held  in  the  spring  of  each  year,  at  such  date 
as  may  be  fixed  by  the  Committee,  when  candidates  who  shall 
prove  competent  and  who  shall  pass  the  best  examinations  shall 
be  designated  to  fill  all  vacancies  on  the  medical  and  surgical 
division  for  the  ensuing  year.  Should  satisfactory  candidates  fail 
to  appear,  other  examinations  shall  be  held  at  such  times  as  may 
be  designated  by  the  Committee.  Successful  candidates  shall  be 
recommended  to  the  Trustees  for  appointment  upon  dates  speci- 
fied in  the  recommendation.     They  shall  nominate  at  their  dis- 

20 


cretion  ex-members  of  the  House  Staff   for  reappointment  on 
other  Divisions  without  competitive  examinations. 


VI.— OF  THE  SUPERINTENDENT. 
i.  The  Superintendent  is  appoi: 
Board  of  Trustees.    He  is  the  executive  officer 


trustees—  I#     The    Superintendent   is    appointed  bv   the 

EXECUTIVE 
OFFICER. 

of  the  Board,  and  responsible  to  them  for  the 
good  order  of  the  house.  He  is  to  see  that  their  regulations  and 
directions  are  promptly  and  efficiently  carried  out,  and  for  that 
purpose  shall  have  general  charge  of  the  Hospital  and  its  belong- 
ings. 

2.  He  shall  have  the  power  to  hire  and  dis- 
miss all  hospital  employees  subject  to  the  orders  of  the  Trustees 
or  Visiting  Committee;  and  it  shall  be  his  duty  to  dismiss  any 
employee  who  shall  be  guilty  of  profanity,  drunkenness  or  other 
gross  misconduct,  reporting  his  action  and  his  reason  therefor  to 
the  Visiting  Committee. 

admission  g.     He  shall  admit  patients  who  have  passed 

AND 

r,IO„1_,Ar,^_  examinations  as  provided  for  in  Article  XIV., 

DISCHARGE.  * 

of  patients.  Sections  2,  3  and  4,  excepting  such  as  he  may 

deem  improper  for  other  than  medical  reasons. 
He  shall  also,  at  his  discretion,  admit  patients  presenting  a  re- 
quest from  one  of  the  Chiefs  of  Clinic  of  the  Vanderbilt  Clinic, 
or  from  an  assistant  authorized  to  sign  his  name,  and  such  other 
patients  as  he  may  deem  advisable,  such  patients  to  be  taken 
directly  to  their  bed  in  the  ward  without  waiting  for  examination. 
He  shall  discharge  all  patients  in  accordance  with  the  regulations 
provided  on  that  subject. 

4.  He  shall  purchase,  under  the  direction  of 
the  Visiting  Committee,  furniture,  provisions,  and  all  other  sup- 
plies required  for  the  Hospital,  and  shall  be  responsible  for  the 

proper  issue  of  the  same. 

21 


5.  He  shall  keep  in  a  book  provided  for  that 
purpose  a  regular  and  accurate  account  of  all  moneys  received  or 
disbursed  by  him  on  behalf  of  the  Hospital,  and  a  record  of  all 
such  contracts  as  he  may  be  authorized  to  make,  which  book,  with 
the  vouchers,  shall  be  laid  before  the  Visiting  Committee. 

6.  He  shall  deposit  all  hospital  moneys  coming 
into  his  hands  with  the  Treasurer,  and  shall  obtain  a  draft  from 
the  Visiting  Committee  upon  the  Treasurer  for  such  sums  as  may 
from  time  to  time  be  required  for  the  use  of  the  house. 

7.  He  shall  submit  to  the  Visiting  Committee, 
monthly,  a  roll  of  all  persons  employed  upon  the  premises,  show- 
ing how  they  are  employed  and  their  rate  of  compensation. 

8.  He  or  his  assistant  shall  visit  every  ward 
at  least  once  a  day,  and  shall  make  weekly  a  "general  inspection" 
of  all  parts  of  the  Hospital.  He  shall  see  that  no  smoking  is  per- 
mitted in  any  of  the  wards,  corridors  or  the  Out-Patient  Depart- 
ment of  the  Hospital. 

9.  He  shall  see  that  the  attendants  are  prop- 
erly instructed  in  regard  to  their  respective  duties  in  case  of  an 
alarm  of  fire. 

10.  When  a  patient  is  dangerously  ill,  he  shall 
notify  (if  possible)  the  friend  previously  designated  by  the  pa- 
tient. If  a  patient  desires  to  converse  with  a  clergyman  or  re- 
ligious person,  he  shall  request  the  person  desired  to  attend. 

11.  On  the  decease  of  a  patient,  the  Super- 
intendent shall  cause  the  body  to  be  removed  to  the  dead-house, 
and  there  safely  kept  till  delivered  to  the  friends  of  the  deceased, 
or  those  responsible  for  its  interment. 

12.  When  any  articles  of  value  or  other  effects 
are  left  by  a  deceased  patient,  the  Superintendent  shall  cause  them 
to  be  labeled  with  the  patient's  name  and  the  date  of  his  decease, 
and  hold  them  for  delivery  to  the  person  authorized  to  receive 
them. 

22 


13.  When  a  patient  is  discharged  or  dies,  the 
Superintendent  shall  cause  the  fact  to  be  recorded  in  the  register, 
mentioning  the  patient's  condition  (whether  cured,  relieved,  etc.), 
along  with  any  circumstance  attending  his  departure,  if  dis- 
charged, which  might  influence  his  future  admission. 

14.  If  any  of  the  Officers,  members  of  the 
Staff  or  Employees  violate  the  regulations,  or  be  guilty  of  any 
misconduct,  it  shall  be  the  duty  of  the  Superintendent  to  report 
the  facts  to  the  Visiting  Committee. 

15.  The  Board  of  Trustees  may  appoint  an 
Assistant  Superintendent  who  shall  perform  such  duties  as  may 
be  assigned  to  him  by  the  Trustees  or  Superintendent.  In  the 
absence  or  disability  of  the  Superintendent  his  duties  shall  be  per- 
formed by  the  Assistant. 

VII.— OF  THE  HOUSE  STAFF. 

how  Im     The  House  Staff  shall  be  appointed  by  the 

Board  of  Trustees  upon  the  recommendation 

of  the  Medical  Board,  but  no  candidate  who  is  not  legally  licensed 

to  practice  medicine  in  the  City  of  New  York  and  registered  with 

the  Board  of  Health  shall  be  eligible  for  duty. 

how  2.     The  House  Staff  shall  consist  of  a  Phy- 

CONSTITUTED.  .    .  .        . 

sician,  two  Surgeons  and  a  Gynaecologist,  a 
first  and  a  second  Senior  Assistant  Physician,  a  Junior  Assistant 
Physician,  two  first  and  two  second  Senior  Assistant  Surgeons, 
two  Junior  Assistant  Surgeons,  an  Assistant  Gynaecologist,  a  Se- 
nior and  a  Junior  Pathologist,  all  of  whom  shall  reside  in  the 
Hospital. 

TO  S,GN  3.     Members  of  the  House  Staff  before  enter- 

AGREEMENT.  .  ,     .        ,      .  ,      „       • 

ing  upon  their  duties  shall  sign  an  agreement 
to  conform  with  all  the  rules  of  the  Hospital  and  to  remain  in 

23 


the  service  to  which  they  are  assigned  for  the  full  term  of  their 
appointment  as  follows : 

The  positions  to  be  filled  are  those  desig- 
nated " Junior"  in  the  following  diagram,  which  shows  the 
order  of  promotion  in  each  successive  six  months'  term  of  the 
two  years'  service. 


24 


4.  Failure  to  conform  with  the  rules  or  to 
satisfactorily  perform  his  duties  shall  subject  the  offending  mem- 
ber of  the  House  Staff  to  removal  by  the  Board  of  Trustees. 

not  respon-  ^_     Xhe  government  and  discipline  of  the  Hos- 

SIBLE    FOR  .... 

government  Plta    ls  in  no  degree  intrusted  to  the  House 

of  hospital.  Staff,  but  they  shall  report  immediately  to  the 

Superintendent  of  the  Hospital  any  serious 
breach  of  discipline,  any  accident  occurring  on  the  Hospital  prem- 
ises, or  anything  coming  under  their  notice  that  would  be  likely 
to  involve  the  Hospital  in  legal  action  or  that  would  reflect  on  the 
good  name  of  the  Institution. 

leaves  of  5      Leave  of  absence  may  be  granted  to  a  mem- 

ABSENCE. 

ber  of  the  House  Staff  who  has  completed  six 
month's  service,  not  to  exceed  ten  days  during  the  first  six  months, 
and  twenty-one  days  during  the  second  six  months  of  the  calendar 
year;  but  leave  will  not  be  allowed  to  accumulate,  nor  will  two 
periods  of  leave  be  granted  in  conjunction. 

applica-  ~     Application  for  leave  of  absence  shall  be 

TIONS    FOR 

leaves  of  made  upon  the  blank  form  provided,  signed  by 

absence.  the  applicant  and  approved  by  the  Physician, 

Surgeon  or  Gynaecologist  in  attendance  upon 
applicants  division,  addressed  to  the  Visiting  Committee  of  the 
Board  of  Trustees  and  presented  to  the  Superintendent  one  week 
before  beginning  of  desired  leave.  The  applicant  shall  remain 
upon  active  duty  until  notified  by  the  Superintendent  of  the  ap- 
proval of  his  request  by  the  Visiting  Committee,  and  until  his 
accepted  substitute  shall  have  reported  for  duty.  He  shall  not 
over-stay  his  leave  and  shall  report  his  return  in  person  to  the 
Superintendent. 

25 


substitutes.  g#    The   applicant   shall   provide   a   substitute 

during  his  absence  who  shall  be  either  a  graduate  in  medicine  or 
a  fourth  year  student  of  medicine,  approved  by  the  Attending 
Physician,  Surgeon  or  Gynaecologist. 

9.  No  substitute  not  legally  licensed  to  prac- 
tice medicine  in  this  city  shall  perform  any  of  the  following 
duties : 

(a)  Administration  of  anaesthetics. 

(b)  Ambulance  duty  of  any  kind,  including  transfers. 

(c)  Prescribing  for  patients,  treating  or  assisting  in  the  treat- 
ment of  cases  in  the  Emergency  Department. 

time  off  10.     When  the  service  will  permit,  members  of 

the  House  Staff  may  be  absent  on  alternate 
week  days  from  6  P.  M.  to  1  A.  M.  and  alternate  Sundays  from 
1  P.  M.  to  1  A.  M.  They  shall  not  be  absent  at  other  times  with- 
out the  consent  of  the  Superintendent. 

(a)  Absences  exceeding  twelve  hours  must 
be  provided  for  by  formal  application. 

(b)  One  of  the  House  Surgeons  shall  always 
be  in  the  Hospital  and  there  shall  always  be  on  duty  two  members 
of  the  Medical  Division,  two  members  of  each  Surgical  Division 
and  two  members  of  the  Pathological-Gynaecological  Division. 
posting  (c)  n0  member  of  the  House  Staff  may  leave 
absence.  the  Hospital  without  "posting"  his  absence  on 
the  roster  at  the  main  entrance.  His  return  shall  be  noted  by  the 
same  means. 

diplomas.  Tl      At  f-fog  expiration  of  their  terms  of  service, 

diplomas  will  be  granted,  upon  the  recommendation  of  the  Medi- 
cal Board,  to  retiring  members  of  the  House  Staff,  if  their  ser- 
vices have  been  acceptable  to  the  Board  of  Trustees. 

26 


"rounds"  by  I2.     The  House  Physician,  House  Surgeon  and 

"HOUSE." 

House  Gynaecologist  shall  visit  each  patient  in 
their  respective  wards  at  least  every  morning  and  evening,  and  be 
prepared  to  report  the  condition  of  the  patients  to  the  attending 
Physician,  attending  Surgeon,  or  attending  Gynaecologist.  They 
shall  record  and  sign  all  prescriptions  and  all  orders  for  the  treat- 
ment of  patients  in  books  provided  for  that  purpose  in  each  ward, 
and  see  that  these  orders  are  properly  carried  out.  Prescription 
books  and  liquor  books  shall  be  sent  to  the  apothecary's  depart- 
ment before  n  A.  M.  and  6  P.  M.  each  day.  There  shall  also 
be  an  "Extra  Diet"  book  in  each  ward,  in  which  shall  be  recorded 
all  orders  for  extra  articles  of  diet.  This  book  must  be  sent  to 
the  kitchen  before  n  A.  M. 

diet.  13.     All  patients  shall  be  furnished  with  the 

regular  house  diet  unless  otherwise  specially  directed  by  the 
attending  Physician,  attending  Surgeon  or  attending  Gynaecol- 
ogist. 


"attending"  j^     jn  any  case  0f  emergency  the  House  Phy- 

called  in  sician,  Surgeon  or  Gynaecologist  shall  request 

emergency.  the    immediate   attendance    of    the    Physician, 

Surgeon  or  Gynaecologist  on  duty,  or  if  he 

cannot  promptly  come,  one  of  the  first  Assistants. 

15.  The  "House"  shall  promptly  notify  the  Su- 
perintendent whenever  the  condition  of  a  patient  is  deemed 
serious. 

consents  r6_    The  "House"  shall  see  that  no  patient  is 

FOR  ,  .... 

operations  sent  to         operating  room  for  operation  until 

legal  consent  has  been  obtained,  unless  author- 
ized to  do  so  by  the  Superintendent. 

27 


ly.  The  House  Physician,  Surgeon  or  Gynae- 
cologist shall  in  no  case  substitute  his  assistant  in  the  performance 
of  any  duty  specially  incumbent  on  himself,  excepting  by  permis- 
sion of  the  Physician,  Surgeon  or  Gynaecologist,  or  in  case  of 
sudden  illness  or  other  emergency,  when  the  Superintendent  shall 
first  be  notified. 

transfer  or  !g#     The  House  Physician,  Surgeon  or  Gynae- 

DISCHARGE  ,        .  ,      „  . 

OF  PATIENTS  cologist   shall  not  remove  patients   from   one 

ward  to  another  without  the  approval  of  the 
Superintendent,  nor  shall  he  discharge  patients.  He  shall  upon 
the  directions  of  the  "Attending"  recommend  to  the  Superin- 
tendent for  removal  those  patients  ready  for  discharge  with  a 
report  as  to  their  condition  as  follows :  Cured,  Improved,  Un- 
improved or  Undesirable.  For  all  but  the  cured  cases  the  reason 
for  the  recommendation  for  discharge  shall  be  given. 

19.  When  a  patient  dies,  the  House  Physician, 
Surgeon  or  Gynaecologist  shall  without  delay  write  the  cause  of 
death  in  the  book  supplied  for  that  purpose  by  the  Board  of 
Health,  which  record  shall  be  copied  by  the  clerk. 

autopsies.  20.     Post-mortem  examinations  shall  only  be 

made  with  the  permission  of  the  Superintendent,  and  only  by  the 
Pathologist  or  his  Assistant,  or  in  his  absence  by  some  one  desig- 
nated by  the  Superintendent. 

examination  2I>     The  House  Physician,  Surgeon  or  Gynae- 

admission  cologist,  or  a  Senior  Assistant,  shall  promptly 

of  patients.  examine  applicants  for  admission,  and  shall  re- 

port the  result  of  such  examination  to  the  Su- 
perintendent, who  will  decide  upon  the  disposition  of  the  case. 
They  shall  visit  applicants  for  admission  to  the  Hospital  at  their 
dwellings  when  so  directed  by  the  Superintendent,  and  report  to 
him  in  regard  thereto. 

28 


22.  It  shall  be  the  duty  of  the  House  Phy- 
sician, Surgeon  and  Gynaecologist  to  visit  private  patients  as  soon 
as  possible  after  their  admission  and  to  report  their  condition  to 
the  "Attending." 

23.  They  shall  visit  each  private  patient  on 
their  reception  at  least  twice  a  day  and  shall  when  possible  per- 
sonally attend  to  all  examinations,  dressings,  catheterizations  and 
treatment  ordered  by  the  "Attending." 

24.  In  the  event  of  both  House  Surgeons 
being  detained  by  Hospital  duties,  private  patients  will  be  attended 
by  the  Senior  Assistant  of  the  division  to  which  they  are  assigned ; 
and  in  the  event  of  his  inability  to  respond  to  call,  the  Senior 
Assistant  on  the  other  surgical  division  shall  be  summoned. 

25.  Unless  otherwise  ordered  only  the 
"House"  shall  accompany  the  "Attending"  in  his  visits  to  private 
patients. 

gratuities  26.     No  member  of  the  House  Staff  shall  re- 

PROHIBITED.  .  ,.  .,,    ,  ,:       . 

ceive  any  compensation  or  gift  from  any  patient 
unless  authorized  to  do  so  by  the  Visiting  Committee.  This  does 
not  affect  the  right  of  a  member  of  the  House  Staff  to  receive  a 
fee,  not  exceeding  five  dollars  for  signing  a  certificate  in  the  case 
of  a  life  insurance  claim,  provided,  however,  that  no  such  fee  shall 
be  accepted  without  the  knowledge  and  approval  of  the  Super- 
intendent of  the  Hospital,  who  will  fix  the  amount  to  be  paid. 

request  27.     Members  of  the  House  Staff  shall  sign  no 

„.__„  ,.  certificates  other  than  the  death  certificates  of 

GATES   TO 

be  referred.  the  Board  of  Health  and  the  insurance  certifi- 

cates above  described.  Requests  for  documents 
relating  to  the  condition  of  patients,  or  for  records  of  patients,  or 
other  official  Hospital  business,  for  use  outside  of  the  Institution, 
shall  be  referred  to  the  Superintendent. 

29 


28.  The  Assistants  shall  attend  the  House 
Physician,  Surgeon  and  Gynaecologist  in  their  morning  visits  to 
the  ward  patients,  and  shall  also  be  present  at  the  regular  visits  of 
the  Physician,  Surgeon  and  Gynaecologist,  and  at  such  other  times 
as  may  be  required. 

histories.  29.     The  Senior  Assistant  Physicians  and  Sur- 

geons and  the  Assistant  Gynaecologist  shall,  under  the  direction 
of  the  Physician,  Surgeon  and  Gynaecologist,  keep  a  record  of 
all  cases  which  occur  in  their  respective  divisions.  In  this  record 
shall  be  entered  the  name  and  occupation  of  each  patient,  the 
probable  cause  and  history  of  the  disease,  the  remedies  used  upon 
and  after  admission,  the  name  of  the  Attending  Physician,  Sur- 
geon or  Gynaecologist,  his  daily  reports  of  the  case,  the  termina- 
tion either  in  recovery,  relief  or  death,  and  such  other  particulars 
as  may  tend  to  illustrate  the  case  and  the  nature  of  the  disease, 
and  in  the  surgical  records  shall  be  entered  also  an  account  of  all 
operations  performed  in  the  Hospital,  with  the  name  of  the  oper- 
ating Surgeon. 

30.  The  histories  are  to  be  arranged  and  filed 
in  accordance  with  the  rules  promulgated  by  the  "History  Com- 
mittee" posted  in  the  History  Room. 


histories  3L     The  histories  of  cases  of  patients  in  the 

NOT   TO    BE 
DIVULGED. 


Hospital   are   under   the    seal   of   professional 


secrecy.  They  shall  remain  in  the  custody  of 
the  Superintendent  and  shall  not  be  communicated  to  any  one 
except  by  his  order. 

emergency  32.     The  Emergency  Department  shall  be  in 

DEPARTMENT.  .  „  , 

charge  of  the  second  Assistant  Surgeon  on  the 
"Attending"  Staff  of  the  division  admitting. 

30 


minor  cases.  ^      Minor  cases  will  ordinarily  be  treated  by 

the  second  Senior  Surgeons,  who  will  hold  themselves  in  readiness 
to  respond  promptly  to  calls.  During  the  absence  of  both  on 
Hospital  duty,  the  first  Senior  Surgeon,  on  emergency  duty,  shall 
be  called  to  attend  unfinished  or  new  cases.  No  case  shall  be 
allowed  to  wait  for  any  particular  Surgeon. 

serious  24.     All  serious  cases  shall  be  seen  promptly 

cases. 

by  the  House  or  first  Senior  Surgeon.  A  sec- 
ond Senior  Surgeon  may  be  relieved  for  his  "time  off"  only  by 
a  member  of  the  House  Staff  of  equal  or  higher  rank. 

35.  No  Junior  shall  assist  in  the  Emergency 
Department,  except  in  case  of  great  emergency,  and  when  any 
member  of  the  House  Staff  may  be  so  directed  by  the  Attending 
Surgeon  or  Superintendent. 

36.  The  doctor  on  duty  in  the  Emergency 
Department  shall  see  every  patient  and  shall  sign  his  name  in  the 
proper  place  after  the  name  and  record  of  the  patient.  His  duty 
in  this  Department  shall  be  considered  paramount.  No  patient 
shall  return  to  this  department  for  further  treatment. 

transfers.  ^j .     No    patient    is    to    be    transferred    after 

having  been  brought  to  this  Hospital,  except  upon  the  approval 
of  the  Superintendent,  to  whom  a  report  of  the  case  shall  be 
made,  giving  the  reason  for  the  transfer.  Application  is  not  to 
be  made  for  the  transfer  of  patients  who  are  not  expected  to  sur- 
vive more  than  a  few  days,  unless  such  patients  are  suffering 
from  a  contagious  disease,  or  their  presence  would  be  a  menace 
to  other  patients  here. 

38.  No  patient  shall  be  transferred  from  the 
wards  to  Bellevue  Hospital  between  the  hours  of  8  P.  M.  and  8 
A.  M.,  except  for  the  reasons  mentioned  above.    All  patients  sent 

31 


to  Bellevue  Hospital  shall  be  accompanied  by  a  brief  history  of 
the  case,  on  blanks  supplied  for  that  purpose,  which  shall  have 
the  signed  approval  of  the  Superintendent. 

S0CIAL  39.     Members  of  the  House  Staff  shall  treat 

RELATIONS 

with  nurses  tne  nurses  with   courtesy,  but  their  relations 

forbidden.  with  them  shall  be  confined  strictly  to  profes- 

sional duties,  and  there  shall  be  no  social  relations  whatever. 
They  shall  not  prescribe  for  or  treat  nurses  except  upon  request 
of  the  Superintendent  of  Nurses. 

40.  Minor  operations  such  as  paracentetis  or 
thoracentesis  are  not  to  be  performed  on  in-door  patients  except 
upon  the  order  of  the  "Attending." 

41.  Cases  suspected  to  be  suffering  from  a 
contagious  disease  shall  be  immediately  isolated  and  reported  to 
the  Superintendent. 

exposure  42,     Members   of  the   House   Staff   shall   not 

OF   PATIENTS.  ,  ,       .      ,  .         .  .      , 

make  any  gynaecological  examination  of  the 
patient  except  in  the  presence  of  a  female  nurse.  Unnecessary 
exposure  of  both  male  and  female  patients  is  to  be  avoided. 

patients'^meals  43.     All  surgical  dressings  and  other  treatment 

of  patients  in  the  wards  shall  be  suspended 
while  patients'  meals  are  being  served,  except  in  urgent  cases. 

44.  Convalescent  ward  patients,  without  ex- 
ception, must  render  such  help  in  the  general  work  of  their  wards 
as  their  condition  will  warrant,  in  response  to  the  demands  of  the 
nurses. 

45.  Discharged  patients  shall  not  return  to 
the  wards  for  dressings  except  upon  written  direction  of  the 
"Attending"  for  individual  cases. 

46.  Members   of   the   House   Staff  shall  not 

32 


engage  in  any  other  business  than  that  of  the  Hospital,  nor  shall 
they  practice  outside. 

hours  for  47.     The  breakfast  hour  for  the  House  Staff 

BREAKFAST. 

shall  be  8  A.  M.  No  breakfast  shall  be  served 
after  8 130  A.  M.,  except  by  special  order  of  the  Superintendent. 

48.  Smoking  in  the  corridors  or  any  part  of 
the  Hospital  used  by  patients  is  prohibited. 

49.  No  instruments,  apparatus  or  supplies, 
medical  or  surgical,  or  Hospital  property  of  any  kind  shall  be  fur- 
nished or  allowed  to  be  taken  outside  the  Hospital  for  private  use. 
The  Visiting  Committee  or  the  Superintendent  only  may  in  par- 
ticular cases  make  exception  to  this  rule. 

signals.  ^o.     It  is  important  that  members  of  the  House 

Staff  should  promptly  respond  to  the  bell  signals  and  telephone 
calls,  and  when  on  duty  word  must  be  left  at  the  Bureau  of  Infor- 
mation if  going  out  of  range  of  the  signal. 

VIII.— OF  THE  APOTHECARY. 

1.  The  Apothecary  shall  compound  and  make 
up  all  medicines  prescribed  agreeably  to  the  formulas  from  time 
to  time  directed  by  the  physicians  and  surgeons.  He  shall  deliver 
no  medicine  or  other  articles  which  are  not  entered  upon  the  pre- 
scription or  record  book.  He  shall  put  up  the  medicines  for  each 
ward  separately,  and  shall  annex  to  them  suitable  labels,  with 
printed  or  written  directions  for  taking  them.  He  shall  keep 
splints,  bandages  and  muslin  of  such  sizes  and  in  such  quantities 
as  may  be  required,  and  shall  issue  the  same  upon  proper  requisi- 
tion. 

2.  He  shall  regularly  attend  the  shop,  and  not 
be  absent  from  the  premises  without  the  Superintendent's  permis- 
sion.   He  shall  keep  the  shop  and  its  belongings  clean  and  in  good 

33 


order,  and  it  shall  remain  open  from  8  o'clock  A.  M.  till  6  o'clock 
P.  M.  He  shall  observe  careful  economy  in  everything  relating 
to  his  department. 

3.  It  shall  be  his  duty,  when  directed  by  the 
Superintendent,  to  assist  in  the  supervision  of  the  male  employees 
and  to  perform  such  other  services  as  will  not,  in  the  opinion  of 
the  Superintendent,  interfere  with  his  routine  duties  as  Apothe- 
cary. 

IX.— OF  THE  HOUSEKEEPER. 

1.  The  Housekeeper  shall  perform  such  duties 
as  may  be  assigned  to  her  by  the  Superintendent,  including  the 
careful  supervision  of  the  work  of  the  female  employees  engaged 
in  the  care  of  apartments  and  corridors,  and  shall  maintain  clean- 
liness throughout  the  house.  She  shall  have  an  oversight  of  the 
linen,  bedding,  household  goods,  furniture,  etc.,  and  shall  report 
to  the  Superintendent  any  abuse  or  extravagant  use  of  the  same. 

X.— OF  THE  CLERK  AT  THE  HOSPITAL. 

I.  The  Clerk  shall  keep  the  Hospital  records 
and  accounts.  He  shall  be  under  the  direction  of  the  Superintend- 
ent. 

XL— OF  THE  ENGINEER. 

I.  The  Engineer  shall  have  charge  of  and  per- 
sonally see  to  the  operation  of  all  machinery  and  apparatus  hav- 
ing to  do  with  power,  lighting,  heating  and  ventilating,  and  shall 
maintain  cleanliness  and  order  in  the  rooms  in  which  they  are  in- 
stalled. He  will  also  be  responsible  for  the  good  order  of  the 
water  and  plumbing  fixtures  and  electrical  equipment.  He  shall 
be  accountable  for  the  economical  use  of  coal  and  steam,  and  it 
shall  be  his  special  duty  to  see  that  the  temperature  desired  be 
maintained  in  all  the  wards  during  the  winter,  and  visit  them 
night  and  day  as  often  as  may  be  necessary  to  secure  this  object. 

34 


2.  The  Engineer  and  his  assistants  shall  at  all 
times  be  subject  to  the  direction  and  control  of  the  Superintend- 
ent, to  whom  the  Engineer  shall  report  at  once  any  misconduct  or 
neglect  of  any  assistant  in  his  department. 

XII.— OF  HOSPITAL  ATTENDANTS. 

i.  Hospital  employees  shall  be  hired  by  the 
Superintendent  with  the  approval  of  the  Visiting  Committee,  in 
such  number  as  the  service  of  the  Hospital  may  require. 

2.  They  shall  be  under  the  control  of  the  Su- 
perintendent and  of  the  heads  of  the  several  departments  in  which 
they  may  be  employed. 

3.  As  far  as  practicable  they  shall  have  as- 
signed to  them  their  regular  duties,  but  will  be  expected  to  yield 
willing  obedience  to  any  reasonable  requirement  of  the  Superin- 
tendent. 

4.  They  shall  not  leave  the  Hospital  without 
the  permission  of  the  Superintendent,  who  shall  assign  them  their 
regular  hours  of  duty  and  recreation. 

5.  No  nurse  or  other  employee  shall  receive 
any  compensation,  gift,  or  bequest  from  any  patient  unless  author- 
ized to  do  so  by  the  Visiting  Committee. 

6.  All  employees  are  hired  only  during  the 
pleasure  of  the  Board. 

XIII.— OF  PATIENTS, 
i".     The  Admission  of  Patients. 

1.  Patients  suffering  from  severe  accidents 
or  serious  illness  shall  be  admitted  to  the  Hospital  at  any  hour  of 
the  day  or  night. 

2.  Other  patients  shall  be  admitted  between  9 
o'clock  A.  M.  and  5  o'clock  P.  M.  They  must  apply  in  person  at 
the  office  of  the  Hospital,  when  they  will  be  examined  and  recom- 

35 


mended  for  admission  or  rejection  by  the  House  Physician,  Sur- 
geons or  Gynaecologist,  or  their  Senior  Assistants,  on  duty.  If 
unable  to  apply  in  person,  they  shall  be  visited  at  their  homes  by 
the  House  Physician,  Surgeon  or  Gynaecologist  on  duty,  or  one 
of  their  Assistants. 

3.  Any  member  of  the  Medical  Board  may 
send  to  the  wards  of  the  Hospital  such  patients  as  he  sees  fit,  giv- 
ing them  a  special  order  for  admission,  subject  to  the  regulations 
of  the  Hospital. 

contagious  4.     No  patient  suffering  under  any  contagious 

disease  shall  be  admitted,  except  such  cases  of 
emergency  as  require  immediate  attention;  and  such  cases  so  ad- 
mitted shall  be  placed  in  the  isolating  room  only. 

5.  There  shall  be  posted  in  the  office  daily  the 
number  of  occupied  beds  in  each  ward. 

out-of-town  5      Application  for  the  admission  of  patients 

PATIENTS.  ,.    .  .     ,  ,  «  ,  ,, 

living  out  of  the  city  must  be  addressed  to  the 
Superintendent  of  the  Hospital  and  accompanied  by  a  certificate 
of  some  respectable  physician,  stating  the  nature  and  probable  du- 
ration of  the  disease. 

payment  j      jf?  jn  the  opinion  of  the  Superintendent, 

OF    BOARD. 

ability  to  pay  exists,  such  charge  as  he  deems 
advisable  up  to  $1.50  per  day  may  be  made  for  the  ward  patients' 
board. 

II.     Rules  for  Patients. 

1.  Patients  admitted  to  the  Hospital  are  for- 
bidden to  use  profane  or  indecent  language;  to  express  immoral 
or  infidel  sentiments ;  to  play  at  any  game  for  money ;  to  smoke 
tobacco  in  the  house,  or  to  procure  for  themselves  or  others  any 
intoxicating  liquors. 

36 


2.  No  patient  shall  be  allowed  to  have  any 
book,  pamphlet  or  newspaper  of  an  immoral  or  indecent  nature. 

3.  No  male  patient  shall  go  into  any  of  the 
women's  wards,  nor  any  female  patient  into  any  of  the  men's 
wards. 

4.  No  patient  shall  enter  the  dead-house,  en- 
gine-room, kitchen,  theatre,  or  any  of  the  attendants'  rooms,  ex- 
cept by  order  of  the  Superintendent  or  other  officer  of  the  house. 

5.  No  patient  shall  leave  the  house  without 
permission  of  the  Superintendent.  When  desiring  to  go  beyond 
the  Hospital  bounds,  patients  must  obtain  a  card  from  the  House 
Physician,  Surgeon  or  Gynaecologist,  at  his  morning  round,  stat- 
ing that  he  has  no  objections,  which  card,  when  countersigned  by 
the  Superintendent,  will  serve  them  as  a  pass,  and  will  be  valid 
for  the  day  upon  which  it  is  given,  but  must  be  surrendered  to  the 
doorkeeper  when  the  patient  goes  out. 

valuables.  g#     Patients    admitted    to   the    Hospital    must 

leave  with  the  Superintendent  for  safe  keeping,  and  for  which  a 
receipt  will  be  given,  any  money  or  other  valuables  they  may  have, 
and  in  case  of  their  failure  to  do  so  the  Hospital  will  not  be  re- 
sponsible for  any  loss  which  may  occur.  The  clothing  of  patients 
will,  if  desired,  be  cared  for,  but  no  responsibility  assumed  for  loss 
or  damage.  All  clothing  infested  with  vermin,  or  for  any  other 
reason  deemed  unfit  to  be  kept  here,  will  be  destroyed  on  the  ad- 
mission of  the  wearer  unless  removed  immediately  by  his  or  her 
relatives. 

7.  No  patient  may  purchase,  or  procure  any 
attendant  to  purchase  for  him,  any  articles  whatever  without  per- 
mission of  the  Superintendent. 

8.  Patients  are  admitted  only  upon  condition 
that  they  and  their  visitors  comply  with  the  rules,  and  failure  to 
do  so  may  necessitate  their  removal. 

37 


XIV.— OF  VISITORS. 

i.  The  regular  visiting  days  at  this  Hospital 
will  be  Sundays,  Wednesdays  and  Fridays,  and  the  hour  from  i 
to  2  o'clock  in  the  afternoon. 

Not  more  than  two  persons  will  be  allowed  to 
visit  a  patient  on  the  same  day. 

notice  of  In  cases  of  alarming  illness,  of  which  due  no- 

tice will  always,  if  practicable,  be  given  to  the 
immediate  relatives  or  friends  of  a  patient,  vis- 
its will  not  be  restricted  to  the  regular  days  or  hours. 

Visitors  must  not  remain  with  patients  longer 
than  the  prescribed  visiting  hours,  and  must  not  converse  with 
any  patient  who  is  not  a  relative  or  friend. 

The  nurses  and  orderlies  will  see  that  these 
rules,  which  are  adopted  for  the  good  of  the  patients,  are  closely 
observed.  They  apply  alike  to  visitors  to  both  men  and  women 
patients. 

2.  All  visitors  are  required  to  leave  when  the 
bell  rings,  at  the  expiration  of  the  visiting  hour. 

packages  3,     Visitors  are  prohibited  from  taking  any- 

„ „.,„,  thing  to  eat  or  drink  into  the  wards.    All  such 

PATIENTS.  & 

must  be  left  with  a  nurse  at  the  entrance  to  the 
ward,  marked  with  the  name  of  the  patient  for  whom  they  are  in- 
tended. After  the  visiting  hour  they  will  be  examined  by  a  med- 
ical officer,  and  if  found  unobjectionable  will  be  sent  to  the  pa- 
tients as  directed. 

XV.— OF  THE  OUT-PATIENT  DEPARTMENT. 
/.     Divisions  and  Physicians,  etc. 

1.  The  Out-Patient  Department  shall  have 
three  divisions  corresponding  to  those  of  the  Hospital,  viz. :  a 
Medical,  Surgical  and  Gynaecological. 


"atten dings."  2.     Each  division  shall  be  in  charge  of  an  at- 

tending Physician,  Surgeon  or  Gynaecologist,  who  shall  be  ap- 
pointed by  the  Board  of  Trustees  on  the  recommendation  of  the 
Medical  Board,  and  shall  have  the  general  direction  and  super- 
intendence of  his  division,  subject  to  the  authority  and  supervision 
of  the  Medical  Board  and  the  Trustees.  They  may  be  called  upon 
to  act  in  the  capacity  of  assistants  to  the  Attending  Physicians, 
Surgeons  and  Gynaecologist  of  the  Hospital,  in  the  event  of  one 
or  more  members  of  the  Attending  Staff  being  unavoidably  absent 
from  the  City. 

deputy  It  shall  be  the  duty  of  the  Attending  Physician, 

"ATTENDINGS."  c  ,        .  ,      .  , 

Surgeon  or  Gynaecologist  to  designate  one  of 
his  assistants,  upon  whom  the  responsibility  for 
the  work  of  his  division  shall  rest  whenever  the  Attending  may 
be  absent,  and  whose  authority  for  the  time  being  shall  be  the 
same  as  that  of  the  principal.  It  shall  be  the  further  duty  of  the 
Attending  to  notify  the  Superintendent  of  the  Hospital  whom  he 
has  designed  for  that  duty. 

assistants.  As  many  Assistant  Physicians,  Surgeons  and 

Gynaecologists  as  may  be  from  time  to  time 
required  shall  be  appointed  by  the  Board  of  Trustees,  on  the  nom- 
ination of  the  Attending  Physician,  Surgeon  or  Gynaecologist  of 
the  division,  who  shall  also  report  to  the  Board  of  Trustees  the 
resignation  or  neglect  of  duty  of  any  assistant. 

The  Visiting  Committee,  if  occasion  requires 
may  assign  a  Physician,  Surgeon  or  Gynaecologist  to  temporary 
duty  at  the  request  of  the  Attending  Physician,  Surgeon  or  Gyn- 
aecologist. 

3.  The  Attending  Physician,  Surgeon  and 
Gynaecologist  of  each  division  may  direct  out-patients  to  be  re- 
ceived into  the  wards  of  the  Hospital. 

39 


charge  for  ^    A  uniform  charge  of  10  cents  will  be  re- 

PRESCRIP- 

tions  and  quired  of  all  patients  prescribed  for,  and  for  all 

dressings.  local  treatments  applied  and  all  surgical  sup- 

plies furnished  (expensive  dressings  may  be 
charged  for  in  proportion  to  the  cost)  except  when  the  Superin- 
tendent, or  person  designated  by  him,  shall  mark  same  free.  The 
money  received  from  these  sources  shall  be  paid  to  the  Super- 
intendent, who  shall  keep  an  account  of  same  and  pay  the  money 
over  to  the  Treasurer. 

clinics.  2.     The    Attending    Physician,    Surgeon    and 

Gynaecologist  may  hold  clinics  at  the  Hospital,  and  may  permit 
a  limited  number  of  students  in  the  class  room  to  witness  the 
treatment  of  patients,  when  the  latter  do  not  object.  No  patient 
shall  be  taken  elsewhere  for  clinical  purposes,  nor  be  exhibited 
without  his  or  her  consent. 

II.    Rules  for  Patients. 

i.  Patients  able  to  pay  for  medical  attendance 
are  not  entitled  to  treatment  in  the  Out-Patient  Department. 

2.  Surgical  cases  will  be  received  between  the 
hours  of  10  A.  M.  and  12  noon,  and  medical  and  gynaecological 
cases  between  the  hours  of  2  and  3  P.  M. 

3.  Profane  or  indecent  language  and  disor- 
derly conduct  or  intoxication  will  not  be  tolerated. 

4.  The  name,  age  and  address  of  each  patient 
will  be  entered  by  a  clerk  in  the  registry  book  and  a  card  will  be 
issued  by  him  to  every  patient,  to  be  presented  to  the  Physician, 
Surgecn  or  Gynaecologist. 

777.     Rules  for  Physician,  Surgeons  and  Gynaecologists. 

1.  Every  prescription  must  be  given  or  oper- 
ation performed  by  a  duly  appointed  Physician,  Surgeon  or  Gyn- 
necologist. 

40 


2.  In  order  to  save  time  and  facilitate  dispens- 
ing, the  formulaae  in  the  out-patient  dose-book  will,  as  far  as  pos- 
sible, be  used  instead  of  extemporaneous  prescriptions. 

quantity  of  g.     JSTot  more  than  four  days'  supply  of  medi- 

limited  c*ne  w^  ^e  ordered  in  one  prescription.    When 

no  more  than  two  or  three  doses  are  needed, 

only  that  amount  must  be  ordered.    The  quantity  prescribed  may 

be  doubled  with  the  consent  of  the  physician,  in  which  case  the 

charge  will  also  be  doubled. 

directions  4#     Distinct   directions    for   use   must   accom- 

FOR   TAKING  ,  .       .  _  , 

medicine  pany  each  prescription,     lhe  order    As  direct- 

ed" must  not  be  used.  The  word  "Poison" 
must  be  put  on  any  prescription  which  may  require  it.  To  reduce 
the  chances  of  error,  poisonous  substances  must  be  largely  diluted 
and  ordered  only  in  quantities  of  eight  doses  or  less.  No  medi- 
cines prescribed  will  be  ordered  to  be  taken  in  drops.  Medicines 
must  be  ordered  in  as  cheap  a  form  as  possible. 

IV.    Rules  for  Dispensing  Medicines. 

i.  The  apothecary  will  only  fill  prescriptions 
signed  by  the  Attending  or  Assisting  Physicians,  Surgeons  or 
Gynaecologists,  and  on  the  Hospital  blanks. 

2.  The  name  and  number  of  the  patient  and 
the  dose  and  time  of  administration  of  the  medicine  must  be 
marked  on  each  bottle.    No  bottle  may  be  marked  "As  directed." 

3.  Poisonous  mixtures  and  those  designated 
for  external  use  shall  be  plainly  marked  "Poison,"  or  "For  ex- 
ternal use,"  or  both,  as  may  be  necessary. 

4.  The  apothecary  may,  in  his  discretion,  re- 
fuse to  dispense  medicine  in  bottles,  presented  by  patients,  which 
are  dirty  or  otherwise  unfit  for  use. 

41 


Rules 

FOR    THE    GOVERNMENT    OF    THE 

TRAINING     SCHOOL 

1.  The  training  of  nurses  shall  be  an  integral 
part  of  the  work  of  the  Hospital. 

2.  A  Superintendent  of  Nurses  shall  be  ap- 
pointed by  the  Board  of  Trustees  on  the  nomination  of  the  Super- 
intendent. 

3.  The  Superintendent  of  Nurses,  under  the 
Supervision  of  the  Superintendent  of  the  Hospital  and  the  Com- 
mittee of  the  Training  School,  have  charge  of  the  nursing  in  the 
Hospital  and  arrange  the  course  of  lectures  and  instruction  for 
the  training  school. 

4.  She  shall  have  supervision  of  all  the  nurses 
in  the  Hospital  and  see  that  the  directions  given  by  the  profes- 
sional staff,  for  the  nursing  and  care  of  all  patients,  are  efficiently 
carried  out. 

5.  She  shall  have  careful  oversight  of  the  pub- 
lic and  private  wards  and  operating  rooms,  and  herself  or  her  as- 
sistant visit  them  with  as  much  frequency  daily  as  is  necessary  to 
that  end.  She  shall  notice  whether  the  food  is  suitably  prepared 
and  served  to  the  patients,  and  report  to  the  Superintendent  any 
failure  in  that  regard. 

6.  She  shall  also  report  at  once  to  the  Super- 
intendent any  serious  neglect  of  duty  by  a  nurse  or  orderly  or 
violation  of  rules  by  a  patient. 

42 


Nurses'    Hours   and    Duties 


HOURS  OF  DUTY. 

1.  The  hours  of  duty  for  nurses  by  day  shall 
be  from  7  o'clock  A.  M.  to  7  P.  M.,  by  night  from  7  o'clock  P.  M. 
to  7  A.  M.,  and  they  must  report  for  duty  promptly  at  the  ap- 
pointed hours. 

2.  All  nurses  are  subject  to  emergency  call, 
day  or  night. 

3.  Each  nurse  shall  have  a  half  day  in  each 
week,  from  1 130  P.  M.  for  recreation,  and  on  other  days  will  have 
one  or  two  hours  (as  hospital  duties  may  permit)  for  out-of-door 
exercise  or  diversion.  On  Sunday  at  least  time  for  one  church 
service  will  be  allowed. 

4.  Nurses  must  be  in  their  rooms  at  10  P.  M., 
and  lights  extinguished  at  10:30  P.  M. 

5.  Permission  to  be  out  later  may  be  had  not 
oftener  than  twice  a  month  and  must  be  obtained  from  the  Super- 
intendent of  the  Training  School  before  7  P.  M. 

6.  This  pass  expires  at  12  midnight.  If  un- 
avoidably detained  explanation  must  be  made  on  the  following 
morning  before  9  o'clock. 

7.  All  nurses  coming  in  after  10  P.  M.  must 
sign  the  register  in  the  Bureau  of  Information,  and  note  thereon 
the  hour  of  return. 

8.  Nurses  must  be  punctual  in  going  to  classes 
and  lectures.  If  ill,  special  permission  to  absent  themselves  must 
be  obtained  from  the  Superintendent  of  Training  School. 

43 


HOURS  FOR  MEALS. 
i.     Breakfast  from  6:30  to  7:30  A.  M.,  dinner 
from  12  to  1 :  15  P.  M.,  Supper  from  5  to  6  P.  M. 

2.  Night  nurses'  breakfast  from  7:30  to  8 
A.  M.,  dinner  at  6:15  P.  M. 

3.  Meals  must  be  promptly  attended  by  the 
nurses  in  turn,  one  nurse  always  remaining  in  the  ward. 

GENERAL  RULES. 

1.  No  ward  property  of  any  description  may 
be  taken  to  nurses'  rooms. 

2.  Visiting  from  ward  to  ward  is  prohibited 
except  upon  hospital  business,  and,  when  off  duty,  nurses  must 
not  return  to  their  wards  without  special  permission. 

3.  While  on  duty,  the  entire  time  of  the  nurse 
belongs  to  her  patients  and  to  the  Hospital.  Unnecessary  con- 
versation or  other  waste  of  time  must  be  avoided. 

4.  Nurses  are  forbidden  to  have  any  social  re- 
lations with  the  Staff,  patients  or  visitors  to  the  Hospital.  All 
intercourse  with  them  must  be  of  a  strictly  professional  character. 

5.  Nurses  must  at  all  times  preserve  a  quiet 
demeanor  in  corridors,  stairways  and  elevators.  No  loud  talking 
or  laughing  will  be  permitted  in  wards  or  corridors. 

6.  The  affairs  and  conditions  of  all  patients 
are  to  be  considered  as  strictly  private.  No  legal  papers  shall  be 
executed  by  them  without  the  knowledge  and  approval  of  the 
Superintendent  of  the  Hospital. 

7.  Nurses,  upon  the  entrance  of  an  officer  or 
stranger  into  the  ward,  shall  at  once  rise,  if  seated,  and  give  all 
visitors  prompt  attention. 

8.  Screens  must  be  used  to  avoid  the  exposure 
of  any  patient. 

44 


9.  All  appliances  and  appurtenances  for  gen- 
eral use  must  be  returned  to  the  Drug  Room  when  no  longer  re- 
quired. 

10.  All  splints,  cradles,  etc.,  to  be  kept  in 
Ward  V.  storeroom  when  not  in  use. 

n.  Empty  bottles  and  medicines  not  in  use 
to  be  returned  to  the  Apothecary. 

12.  All  instruments  belonging  to  the  wards, 
operating  rooms,  dispensary  or  emergency  department,  needing 
repairs,  are  to  be  left  in  the  Drug  Room  before  g  A.  M.  on  Tues- 
days together  with  a  list  of  the  same. 

HEAD  NURSES. 
i.  The  head  nurse  of  each  ward  shall,  under 
the  supervision  of  the  Superintendent  of  the  Training  School,  have 
entire  charge  and  responsibility  in  her  ward.  She  shall  see  that 
all  patients  are  kindly  and  attentively  cared  for,  that  strict  cleanli- 
ness is  enforced  in  the  case  of  each  patient  and  in  the  ward  itself ; 
that  each  patient  is  thoroughly  bathed  or  sponged  as  soon  after 
entering  the  ward  as  the  condition  of  the  patient  will  permit,  and 
is  thereafter  regularly  bathed  or  sponged  once  in  each  week  or 
oftener  if  required;  that  the  head  and  feet  of  each  patient  are 
cleansed  at  least  twice  in  each  week,  and  the  faces  and  hands  of 
all  patients  are  washed  and  their  hair  combed  each  morning,  and 
as  much  oftener  as  is  necessary.  All  patients,  who,  in  the  opinion 
of  the  physicians  and  surgeons,  are  able,  shall  take  their  baths  in 
the  bathroom. 

2.  Patients  suffering  from  shock  or  severe  in- 
juries must  be  placed  between  blankets  and  bathed  only  by  special 
order. 

3.  The  head  nurse  of  each  ward  shall,  when 
possible,  supervise  the  serving  of  meals  to  patients,  and  shall  see 
that  such  meals  are  properly  served  without  unnecessary  waste. 

45 


Dishes  not  belonging  to  the  ward  and  all  surplus  food  must  be 
promptly  returned  to  the  Kitchen  or  Diet  Kitchen. 

4.  Diet  requisitions  for  following  day  must  be 
left  in  the  office  of  the  Superintendent  of  Training  School,  not 
later  than  5:10  P.  M. 

5.  A  head  nurse,  when  taking  and  giving  up 
charge  of  a  ward,  is  to  take  an  inventory  of  the  ward  furnishings, 
informing  the  Superintendent  of  the  Training  School  of  any  short- 
age ;  otherwise  she  will  be  held  responsible. 

6.  A  weekly  requisition  for  all  necessary  ward 
housekeeping  supplies  shall  be  made  by  the  head  nurse  and  the 
books  left  in  the  office  of  the  Superintendent  of  Training  School 
on  Saturday  morning. 

7.  Borrowing  supplies  is  prohibited. 

8.  When  coming  on  duty  each  morning,  the 
Head  Nurse  is  to  read,  to  her  assistants,  all  orders  given  during 
the  night,  inquire  into  the  condition  of  patients,  and  make  rounds 
in  the  wards,  lavatories,  linen  room  and  pantry,  seeing  that  every- 
thing is  in  order  before  the  dismissal  of  the  Night  Nurse. 

9.  Before  going  off  duty,  the  Head  Nurse  or 
nurse  in  charge  must  know  the  condition  of  each  patient,  and 
make  rounds  through  the  wards,  lavatories,  linen  room  and  pantry, 
to  see  that  everything  is  in  order  for  the  Night  Nurse. 

10.  New  patients'  clothes  are  to  be  listed, 
mortuary-box  left  completely  equipped,  etc.  The  Night  Nurse  is 
to  do  the  same  before  going  off  duty. 

11.  New  diet  lists  are  to  be  made  out  each  day 
and  necessary  changes  made  in  medication  and  lavatory  lists. 

12.  New  orders  during  the  day  must  be  added 

promptly. 

13.  The  Head  Nurse  is  to  assign  to  each  As- 
sistant Nurse  her  regular  duties,  and  hold  her  responsible  for  the 

same. 

46 


14-  The  assistant  nurses  must  regard  them- 
selves as  subordinate  to  the  Head  Nurse  and  obey  her  orders. 

15.  The  Nurse  in  Charge  will  be  held  respons- 
ible for  the  whereabouts  of  her  patients. 

16.  If  absolutely  necessary  for  the  Head 
Nurse  to  leave  her  ward,  she  must  inform  the  nurse  left  in  charge 
as  to  her  destination. 

17.  Whenever  it  is  possible,  she  should  send 
an  assistant  nurse  in  preference. 

18.  Refrigerators,  fruit  boxes  or  cupboards 
and  clothing  closets  must  always  be  kept  locked  and  keys  left  on 
Head  Nurse's  table. 

19.  Mistakes  in  medicines,  the  presence  of 
Vermin  and  of  Bed-sores  must  be  reported  at  once  to  the  Super- 
intendent of  Training  School. 

20.  The  nurse  is  responsible  for  preparation 
for  catheterization,  and  of  all  solutions  and  dressings  required 
for  orderly  cases.  She  is  to  supervise  the  work  of  the  orderlies 
in  the  wards,  and  to  report  any  neglect  or  insubordination. 

21.  She  must  also  know  that  patients  are  prop- 
erly prepared  for  operation,  instructing  orderly  as  to  methods  and 
dressings  required. 

22.  The  nurse  must  not  allow  orderly  to  take 
linen  from  the  linen  closet. 

23.  The  nurse  who  takes  a  patient  to  the  Op- 
erating Room,  is  to  remain  with  her  until  dismissed  by  the  Oper- 
ating Room  Nurse. 

24.  A  note  of  any  articles  borrowed,  must  be 
signed  by  the  borrower  and  placed  on  file  in  the  ward  until  the 
articles  are  returned. 

25.  The  badge  must  always  be  worn  by  the 
nurse  in  charge  at  the  time. 

26.  It  is  the  duty  of  the  Head  Nurse  to  report 

47 


promptly  in  writing  to  the  Superintendent  or  his  assistant,  any- 
thing requiring  attention,  and  to  report  before  5  P.  M.  any  fail- 
ure of  the  supply  of  milk,  ice,  etc. 

27.  Each  Head  Nurse  will  be  held  responsible 
for  the  condition  of  her  ward,  including  the  pantry,  closets  and 
lavatory,  and  for  the  clean  and  serviceable  condition  of  all  uten- 
sils. She  is  entirely  responsible  for  the  condition  of  the  floors, 
and  the  work  of  the  maid  in  general. 

28.  Dust  on  the  floors  should  be  brushed  up 
promptly. 

29.  If  the  maid  is  negligent  or  in  any  way  in- 
subordinate, the  matter  should  be  immediately  reported. 

30.  The  Head  Nurse  will  hold  the  nurse  in 
charge  of  diets  responsible  for  the  setting  of  the  trays,  heating  of 
dishes,  serving  of  meals,  and  the  comfort  of  the  patients  while 
partaking  of  them. 

31.  No  food  is  to  be  left  in  the  ward.  Nour- 
ishment glasses  and  dishes  used  between  meals  must  be  removed 
from  the  ward  and  washed  by  the  nurse. 

7,2.  Isolated  dishes  and  trays  must  be  marked 
with  adhesive  plaster  and  kept  separate.  The  Diet  Nurse  is  to 
wash  these,  after  the  others  are  put  away. 

33.  Dishes  will  be  counted  every  Friday,  when 
those  broken  during  the  week  will  be  exchanged.  A  record  must 
be  kept  of  such  dishes ;  also  a  piece  of  each  broken  or  worn  article 
for  exchange. 

34.  An  accurate  account  must  be  kept  of  the 
condition  and  stock  of  the  linen  of  the  ward.  Articles,  to  be 
mended  or  exchanged,  are  to  be  at  once  placed  in  a  bag  for  the 
purpose  and  sent  to  the  sewing  room  each  Friday,  a  list  being 
entered  in  the  Linen  Room  Book  and  marked  "For  Exchange." 

35.  Hot  water  bags,  ice  caps,  rings,  tubes,  ca- 

48 


theters,  thermometers  and  hypodermic  syringes  must  be  counted 
once  a  week,  and  noted  in  inventory. 

36.     Economy  is  exacted  in  every  department. 

ADMISSION  OF  PATIENTS. 

1.  When  a  patient  is  admitted,  pulse,  respira- 
tion and  temperature  must  be  taken  and  reported  to  the  senior 
house  officer  of  that  service.  A  complete  list  of  his  or  her  clothing 
and  effects  must  be  made  and  recorded  in  a  clothing  book  pro- 
vided for  the  purpose  (together  with  the  number  of  the  box  where 
deposited),  and  the  entry  signed  by  the  receiving  nurse. 

2.  The  nurse  in  charge  at  the  time,  must  de- 
posit all  money  and  valuables  in  the  Bookkeeper's  office,  and  take 
a  receipt  for  the  same  in  the  book  supplied  each  ward  for  that 
purpose. 

3.  If  on  listing  clothing  there  be  any  vermin 
found,  the  clothes  must  be  well  wrapped  in  newspaper,  tagged 
and  sent  to  the  box  provided  for  this  purpose;  notice  should  at 
same  time  be  left  in  office  of  the  Superintendent  of  Training 
School,  as  well  as  in  office  of  the  Superintendent  of  the  Hospital 
or  his  assistant. 

4.  If  a  patient  reaches  a  ward  during  the  day 
without  a  card,  the  fact  must  be  reported  at  once  in  writing,  at  the 
entry  clerk's  office;  if  during  the  night,  it  must  be  reported  the 
following  morning  before  9  A.  M. 

DISCHARGE  OR  DEATH  OF  PATIENTS. 

1.  When  a  patient  is  discharged,  he  or  she 
must  be  properly  dressed,  and  the  bedside  card,  taken  by  the 
nurse,  accompanied  by  the  patient,  to  the  office  where  any  money 
or  valuables  previously  left  for  safe  keeping  will  be  surrendered 
upon  return  of  receipt. 

2.  When  a  patient  dies,  the  card,  after  being 

49 


signed  by  the  senior  house  officer  of  the  division,  must  be  taken 
to  the  office  by  a  nurse.  When  the  remains  are  ready  for  removal, 
the  fact  must  be  reported  at  the  entry  clerk's  office.  Before  re- 
moval the  body  must  be  inspected  and  rings  or  other  valuables 
found  thereon  deposited  in  the  Bookeeper's  office. 

3.  The  body  must  ordinarily  be  ready  for 
removal  from  the  ward  within  one  hour. 

4.  The  clothing  of  the  deceased  must  be  care- 
fully collected  and  taken  to  the  entry  clerk's  office  and  his  receipt 
obtained  therefor. 

5.  The  receipt  for  valuables  must  be  returned 
to  the  bookkeeper's  office. 

6.  When  a  patient  is  discharged,  transferred, 
or  dies,  the  admission  card  must,  if  possible,  be  signed  at  once  by 
the  Doctor  and  sent  to  the  entry  clerk's  office.  If  the  signature 
of  the  Doctor  cannot  be  promptly  procured,  the  card  must  be 
sent  without  the  requisite  signature. 

NIGHT  NURSES. 

1.  Night  nurses  are  to  remain  in  bed  from 
10  a.  m.  to  5  p.  m.  They  are  not  to  leave  the  Hospital  for  the  day 
without  special  permission.  They  may  attend  one  church  service 
on  Sunday  with  the  knowledge  and  approval  of  the  Superintend- 
ent of  the  Training  School. 

2.  When  on  duty  they  are  to  remain  strictly 
on  the  ward  assigned  them,  unless  sent  elsewhere  by  the  Super- 
vising Night  Nurse. 

3.  In  any  case  of  doubt,  they  should  report 
to  the  Supervising  Night  Nurse,  before  calling  the  doctor. 

ORDERS  AND  ROUNDS. 

1.  All  orders  given  by  a  member  of  the  house 
staff  shall  be  written  in  the  order  book  and  signed  by  him.  The 
nurse  must  note  the  time  the  order  is  given. 

59 


2.  The  nurses  shall  accompany  the  attend- 
ing on  his  rounds  and  render  such  assistance  or  give  such  informa- 
tion as  they  can  when  called  for.  They  shall  note  the  temperature 
and  pulse  of  each  patient  as  ordered.  They  shall  apply  minor 
dressings  and,  when  required,  assist  the  house  staff  in  the  per- 
formance of  their  duties  on  the  ward. 

3.  Any  unfavorable  change  in  the  condition 
of  a  patient  shall  at  once  be  reported  to  the  senior  member  of  the 
service  on  duty. 

VACATION. 
1.     All  nurses  are  granted  three  weeks'  vaca- 
tion in  each  year.     For  other  time  lost,  deduction  may  be  made 
from  their  moneyed  allowance. 

ORDERLIES. 

1.  Orderlies  shall  be  subject  to  the  direction  of 
the  nurse  in  charge  of  the  ward,  and  shall  respect  her  authority. 

2.  Any  question  of  authority  or  neglect  of 
duty  must  be  reported  at  once  to  the  Superintendent  of  Training 
School  or  the  Superintendent  of  the  Hospital. 


51 


DATE  DUE                     j 

t 

DEMCO  38-296 

tthe 


COLUMBIA  UNIVERSITY  LIBRARIES 


0041071972 


RA982.K48  N431 

1909 
New  York  (City)  Roosevelt  hospital 


l 


i 


